Pain Medicine has evolved tremendously in recent years. The Center for
Sports Neurology and Pain Medicine offers extremely effective strategies
to treat pain that don’t involve medications and the related side-effects
and complications that may range from occasional nuisance to catastrophic.
We are Neurological Pain Medicine specialists and employ a Neurologically
oriented approach to acute, sub-acute, chronic, nociceptive and neuropathic
pain. While we are expert in the rational and judicious prescription of
medications for pain, we focus on opportunities to apply the Neuromodulation
techniques at our disposal.
Neuromodulation is the alteration of nerve activity through targeted delivery
of a stimulus, such as electrical stimulation or chemical agents, to specific
neurological sites in the body. In other words, we can turn up or turn
down and off the specific peripheral nerves that are sending pain signals
to reduce and/or eliminate pain. We can help enhance and improve your
physical function, professional and overall quality of life, sports performance,
and self-esteem through neuromodulation.
We have successfully used Neuromodulation techniques on elite and professional,
as well as collegiate and high-school/youth athletes to eliminate pain
– allowing them to pursue and excel in high level, competitive,
and aggressive physical activities without pain. In addition, we have
successfully used these techniques in consultation with our expert Cedars-Sinai
Kerlan-Jobe Institute surgery partners before and after surgery (and in
instead of surgery).
Not all of our patients are athletes. In fact, ,any of our patients are
working individuals who need to continue on the job without pain, elderly
patients who want to maintain their physical function, and students who
need to focus on studies and seek us out because they are tired of taking
medications for pain relief. They are interested in safe and effective
therapy options that eliminate medication-related side effects and reduce
the unwanted exposure to opioid or narcotic medications. Listed below
are examples of commonly used, safe, minimally invasive, and effective
ways to alter peripheral nerve activity and pain through Neuromodulation.
Myoscience iovera°® Technology
Cryoablation has been used extensively for pain control over the years,
but the newest technologies are far more precise relative to the temperatures
applied and have a form factor that allows easy, safe, effective and minimally
invasive in-office treatment.
Myoscience’s iovera°® technology is a cryoablation tool typically used at the Center under ultrasound guidance
to “freeze” selected superficial sensory nerves for the treatment
of knee, foot, rib and upper extremity pain as well as headache. The procedure
usually lasts approximately 15-30 minutes. Patients may feel a cool, warm,
or tingling sensation, but not pain. The iovera cryoablation does not
“kill” nerves. The target nerve will eventually regenerate
(potentially after several months or longer), but can be re-treated if
Bioness’ StimRouter peripheral nerve implants offer a safe, effective and minimally invasive
way to target a specific peripheral nerve and deliver precise, focused
electrical stimulation to block chronic pain. These procedures are performed
with light sedation in our Kerlan-Jobe Surgery Center. The procedure involves
placing a small electrical lead under the skin near the target nerve,
using ultrasound guidance for precision. The procedure lasts approximately
30 minutes. During follow up, our health professionals and StimRouter
experts assist in programming a personalized external pulse transmitter
(applied to the skin overlying the implanted electrode) and remote. StimRouter
empowers the implanted patient to have complete, customized wireless control
in delivering the stimulation to the lead, and most importantly, relieving pain.
Radiofrequency Denervation (Rhizotomy)
Radiofrequency forms of Neuromodulation offer safe, effective and minimally
invasive ways to target peripheral nerves and deliver precise, focused
stimulation to block chronic, peripheral nerve pain. These procedures
are performed in the Kerlan-Jobe Surgery Center. The procedure involves
using a fluoroscope x-ray or ultrasound to visualize target structures.
An electrode is temporarily placed adjacent to the nerve structure to
be treated so that a radiofrequency signal can deliver carefully controlled
stimulation (either continuous or in “pulses”) to a target
nerve. This signal prevents nerves from sending pain signals and results
in desensitization, reduction and/or elimination of pain. The procedure
lasts approximately 15-30 minutes. There is light sedation and anesthesia
involved to help with relaxation and comfort.